Posterior Leg and Ankle Joint

Question 1

Posterior Aspect of the Leg Bones

Answer 1

Question 2

Muscles of the Posterior Compartment

Answer 2

7 muscles (3 superficial, 4 deep)

Superficial muscles all insert on posterior surface of calcaneous via Tendocalcaneous

Tendons of deep muscles pass behind medial malleolus to plantar surface of foot (except popliteus)

Question 3

Superficial Muscles - Gastrocnemius

Attachments (Medial and Lateral head)

Answer 3

Medial head: Popliteal surface of the femur, superior to the medial condyle

Lateral Head: Lateral aspect of the lateral condyle of the femur

Question 4

Superficial Muscles - Gastrocnemius

Innervation

Answer 4

Tibial nerve (S1, S2)

Question 5

Superficial Muscles - Gastrocnemius

Function

Answer 5

Plantarflexes ankle and flexes knee

Question 6

Superficial Muscles - Plantaris

Attachments

Answer 6

Lateral supracondylar line of femur (proximal to the lateral head of gastrocnemius)

Question 7

Superficial Muscles - Plantaris

Innervation

Answer 7

Tibial nerve (S1, S2)

Question 8

Superficial Muscles - Plantaris

Function

Answer 8

Assists plantarflexion of ankle

Question 9

Superficial Muscles - Soleus

Attachments

Answer 9

Soleal line of Tibia, upper 1/3 of posterior fibula. Tendinous arch between bony attachments

Question 10

Superficial Muscles - Soleus

Innervation

Answer 10

Tibial nerve (S1, S2)

Question 11

Superficial Muscles - Soleus

Function

Answer 11

Plantarflexes ankle joint

Question 12

Deep Muscles - Popliteus

Attachments

Answer 12

Lateral condyle of the femur (pit for popliteus) and lateral meniscus to the popliteal area of the tibia (above the soleal line)

Question 13

Deep Muscles - Popliteus

Innervation

Answer 13

Tibial nerve (L4, L5, S1)

Question 14

Deep Muscles - Popliteus

Function

Answer 14

Unlocks the knee joint by laterally rotating the femur on the fixed tibia

Question 15

Deep Muscles - Flexor Digitorum Longus

Attachments

Answer 15

Posterior surface of Tibia to the base of the distal phalanx of digits 2-4

Question 16

Deep Muscles - Flexor Digitorum Longus

Tibial nerve (L5, S1, S2)

Answer 16

Question 17

Deep Muscles - Flexor Digitorum Longus

Function

Answer 17

Flexes lateral 4 digits. Weak plantarflexor of ankle.

Question 18

Deep Muscles - Flexor Hallucis Longus

Attachments

Answer 18

Posterior surface of Fibula to the base of the distal phalanx of the hallux

Question 19

Deep Muscles - Flexor Hallucis Longus

Innervation

Answer 19

Tibial nerve (L5, S1, S2)

Question 20

Deep Muscles - Flexor Hallucis Longus

Function

Answer 20

Flexes Hallux and is a weak plantarflexor of the ankle

Question 21

Deep Muscles - Tibialis Posterior

Attachments

Answer 21

Posterior surface of tibia and fibula, and the inerosseous membrane to the tuberosity of the navicular, cuneiforms, cuboid, sustentaculum tali of calcaneus, and the base of the 2nd, 3rd and 4th metatarsals

Question 22

Deep Muscles - Tibialis Posterior

Innervation

Answer 22

Tibial nerve (L4, L5)

Question 23

Deep Muscles - Tibialis Posterior

Function

Answer 23

Plantarflexes ankle and inverts foot

Question 24

Tendons of the Deep Muscles

Tibialis Posterior

Answer 24

Tendon passes deep to Flexor Digitorum Longus.

Groove posterior to the medial malleolus

Question 25

Tendons of the Deep Muscles

Flexor Hallucis Longus

Answer 25

Grooves the posterior surface of the lower end of the tibia, the posteror surface of the talus

Question 26

Tendons of the Deep Muscles

Arrangement of tendons at the ankle joint from medial to lateral:

Answer 26

Tibialis Posterior

Flexor Digitorum Longus

Flexor Hallucis Longus

Tom, Dick and Harry

Question 27

Flexor Retinaculum

Path

Posterior tibial vessels/nerve

Answer 27

Medial malleolus to calcaneous

Found between FDL and FHL tendons

Question 28

Arteries of Posterior Leg

Posterior Tibial Artery

Answer 28

Terminal branch of popliteal artery between heads of gastrocnemius and deep to soleus to run on surface of TP and FDL.

Gives fibular artery as a branch and terminates and medial and lateral plantar arteries in the foot.

Question 29

Arteries of Posterior Leg

Fibular artery

Answer 29

Runs medial to the fibula - usually within FHL

Question 30

Nerves of the Leg

Answer 30

Question 31

Tibial Nerve

Route and Branches

Answer 31

Passes between heads of gastrocnemius and deep to tendinous arch of soleus. Between FHL and FDL at ankle joint.

Terminal branches that supply sole of foot - medial and lateral plantar nerves.

Question 32

Cutaneous innervation of leg

Answer 32

Question 33

Inferior Tibiofibular Joint

Answer 33

Question 34

Ankle Joint

Malleolar Mortise

Answer 34

Formed from distal ends of tibia and fibula. Articulates with trochlea of talus

Question 35

Capsule and Ligaments

Attachments, weak points and support

Answer 35

Around articular margins. Anteriorly extends onto neck of talus

Weak anteriorly and posteriorly

Supported laterally and medially by strong Collateral Ligaments

Question 36

Lateral Collateral Ligaments

Red

Green

Blue

Answer 36

Anterior Talofibular to the neck of the talus

Posterior Talofibular to the lateral tubercle of the talus

Calcaneofibular to the lateral surface of calcaneous

Question 37

Medial Collateral Ligament (deltoid)

Fans out from medial malleolus and has 4 parts

Answer 37

1) Anterior Tibiotalar
2) Tibionavicular
3) Tibiocalcaneal
4) Posterior Tibiotalar